下肢机器人治疗脑卒中后下肢运动障碍的效果及对患者步行和平衡能力的影响  

The effect of lower limb robot in the treatment of lower limb movement disorders after stroke and its influence on walking and balance ability of patients

作　　者：孙建淼 张孟利 权璐 杨傲然[3] Sun Jianmiao;Zhang Mengli;Quan Lu;Yang Aoran(Department of Rehabilitation,the Second Affiliated Hospital of Air Force Military Medical University,Xi′an 710038,China;Department of Rehabilitation,the First Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710061,China;Department of Rehabilitation,Beijing Rehabilitation Hospital,Capital Medical University,Beijing 100144,China)

机构地区：[1]空军军医大学第二附属医院康复科,西安710038 [2]西安交通大学第一附属医院康复科,西安710061 [3]首都医科大学附属北京康复医院康复科,北京100144

出　　处：《中国医药》2024年第11期1654-1658,共5页China Medicine

基　　金：国家重点研发计划(2020YFC2004303)。

摘　　要：目的分析下肢机器人治疗脑卒中后下肢运动障碍的效果及对患者步行和平衡能力的影响。方法选取2022年1月至2023年11月于空军军医大学第二附属医院住院的110例脑卒中后下肢运动障碍患者。按照随机数字表法将其分为常规组和观察组,各55例。常规组给予常规康复训练,观察组在常规组基础上给予下肢机器人治疗。比较2组临床疗效、6 min步行试验(6MWT)距离及Berg平衡量表(BBS)、简式Fugl-Meyer运动功能评分量表(FMA)、脑卒中专用生活质量量表(SS-QOL)评分、下肢改良Ashworth量表(MAS)分级、血清神经肽Y(NPY)、脑源性神经营养因子(BDNF)、神经生长因子(NGF)水平。结果观察组总有效率高于常规组[94.5%(52/55)比74.5%(41/55)],差异有统计学意义(P=0.004)。治疗后观察组6MWT距离及BBS、FMA、SS-QOL评分长于/高于常规组,MAS分级情况优于常规组,血清NPY水平低于常规组,血清BDNF、NGF水平高于常规组,差异均有统计学意义(均P<0.05)。结论下肢机器人可有效改善脑卒中后下肢运动障碍患者步行能力、平衡能力、运动能力,下调血清NPY表达量,上调血清BDNF、NGF表达量,提高生存质量,效果显著。Objective To analyze the effect of lower limb robot in the treatment of lower limb movement disorders after stroke and its influence on walking and balance ability of patients.Methods A total of 110 patients with lower limb movement disorders after stroke who were hospitalized in the Second Affiliated Hospital of Air Force Military Medical University from January 2022 to November 2023 were selected.According to the random number table method,they were divided into the routine group and the observation group,with 55 cases in each group.The routine group was given routine rehabilitation training,and the observation group was given lower limb robot therapy on the basis of the routine group.The clinical efficacy,6-min walk test(6MWT)distance and Berg balance scale(BBS),simplified Fugl Meyer motor function scale(FMA),stroke specific quality of life scale(SS-QOL)scores,lower limb modified Ashworth scale(MAS)grading,levels of serum neuropeptide Y(NPY),brain-derived neurotrophic factor(BDNF),and nerve growth factor(NGF)were compared between the two groups.Results The total effective rate of the observation group was higher than that of the routine group[94.5%(52/55)vs 74.5%(41/55)](P=0.004).After treatment,the 6MWT distance,BBS,FMA and SS-QOL scores of the observation group were longer/higher than those of the routine group,the MAS grade was better than that of the routine group,the serum NPY level was lower than that of the routine group,and the serum BDNF and NGF levels were higher than those of the routine group(all P<0.05).Conclusion Lower limb robot can effectively improve the walking ability,balance ability and motor ability of patients with lower limb movement disorders after stroke,down-regulate the expression of serum NPY,up-regulate the expression of serum BDNF and NGF,and improve the quality of life,with significant effects.

关 键 词：脑卒中 下肢机器人 下肢运动障碍 步行能力 平衡能力 

分 类 号：R743.33[医药卫生—神经病学与精神病学]